Endorsement Form - MnSCU System Human Resources

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Minnesota State Colleges and Universities
Luoma Leadership Academy Program
Supervisor and President/Vice Chancellor Endorsement
A member of your staff has been nominated and has applied for participation in the Luoma Leadership
Academy and requests that you complete the form on the following page.
The Luoma Leadership Academy is a distinguished development program facilitated by The Chair
Academy of Mesa, Arizona and sponsored through the MnSCU System Office. It is designed to provide
the leadership theories, practices, and skills needed to support leaders, and those striving to become
leaders, to lead their respective departments, colleges and universities more effectively. The program is
inclusive and focuses on preparing mid-level leaders.
The program consists of two 5-day sessions scheduled for July 12–17, 2015 and July 10-16, 2016, and a
one-day development activity scheduled during the winter. During the year, participants will work on
team-based action learning projects, as well as their own individual development plan. Participants
should plan to devote at least 16 hours per month to the action learning project. They will also meet
regularly with a campus mentor.
Cost for the program is shared between colleges and universities, which pay for hotel and transportation
costs, and the MnSCU System Office, which pays for program costs. Approximate cost for colleges and
universities is $995 per one-week session (a total of $1990 for the program).
Participants must have the support and approval of their supervisor and college/university president
in order to participate in the program.
The application deadline is March 9, 2015. Please complete the endorsement form on the reverse and
return it before that date.
Acceptance into the program will be determined by a selection committee. Applicants will be notified by
mid-April.
Please complete and save the following form to your computer.
Send the completed form with signatures to:
Cindy Schneider, Human Resources
Minnesota State Colleges and Universities
30 7th St. E., Suite 350
St. Paul, MN 55101-7804
Fax: 651/297-3145
e-mail: cindy.schneider@so.mnscu.edu (as a PDF only – signatures required)
(OVER)
Minnesota State Colleges and Universities
Luoma Leadership Academy Program
2015 - 2016 Endorsement Form
Deadline: March 9, 2015
Applicant:
Name:
Title:
Department:
College/University/MnSCU System Office:
Address:
Supervisor:
Name:
Title:
Department:
College/University/MnSCU System Office:
Address:
Please check one box:
I support this candidate’s application into the Luoma Leadership Academy Program.
I do not support this candidate’s application at this time.
Signature:
Date:
If you would like to include any comments about the applicant, please add them below:
President/Vice Chancellor:
Please check one box:
I support this candidate’s application into the Luoma Leadership Academy Program. If selected,
my college/university will cover the hotel and travel expenses for this candidate. Hotel costs are
$995 per week (for a total of $1990 for the entire program).
I do not support this candidate’s application at this time.
President/Vice Chancellor (print):
Date:
Signature:
If you would like to include any comments about the applicant, please add them below:
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